Mastectomy with reconstruction for early-stage breast cancer was tied to higher complications and cost compared to other guideline-based treatments, according to research published in the Journal of the National Cancer Institute.1

The current guideline-based treatment options for early-stage breast cancer include lumpectomy with whole breast irradiation (WBI), lumpectomy with brachytherapy, mastectomy, mastectomy with reconstruction, or lumpectomy alone in older women.       

Benjamin D. Smith, MD, of the department of radiation oncology at the University of Texas M.D. Anderson Cancer Center and colleagues sought to examine the treatments options comparative costs and complications. Data was obtained from the MarketScan database for younger women and SEER-Medicare database for older women. The researchers identified 105,211 women with early breast cancer.

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The most commonly used treatment for early breast cancer was lumpectomy with WBI. Compared to lumpectomy with WBI, mastectomy with reconstruction was tied to a higher complication risk in both younger women (Marketscan 54.3% vs 29.6%, RR 1.87, P < .001) and older women (SEER-Medicare 66.1% vs 37.6%, RR 1.75, P < .001). Further, mastectomy with reconstruction was associated with higher adjusted total costs in both groups (Marketscan $22,481 more and SEER-Medicare $1,748 more). Likewise, mastectomy with reconstruction was associated with higher complication-related costs.1

“We believe that this research is helpful to frame the conversation between a woman and her physicians regarding the trade-offs between lumpectomy with whole breast irradiation and mastectomy with reconstruction. While mastectomy with reconstruction is sometimes the best treatment for an individual patient, it is important for patients to understand the potential for complications, some of which can be quite significant,” Dr Smith said in a press release.2


1. Smith BD, Jiang J, Shih YC, et al. Cost and complications of local therapies for early-stage breast cancer. J Natl Cancer Inst. 2017;109(1).

2. Different breast cancer treatment options vary widely in their cost-effectiveness [news release]. Oxford University Press; April 10, 2017. Accessed April 23, 2017.